Abstract
Late smear conversion after 2 months of tuberculosis (TB) treatment represents a major problem. Objectives: Isolate the environmental, clinical, radiological, bacteriological and biological factors associated with a delayed smear conversion. Methods: We analyzed records from 60 tuberculosis patients, from which 20 had a delayed smear conversion. Those patients were compared in terms of clinical presentation, radiological, bacteriological and biological results, environmental data and evolution under treatment. Results: Smoking was significantly associated with delayed smear conversion (85% of patients with a late conversion were smokers versus 47.5%,p 0.05), as well as history of diabetes type II (25% with late smear conversion versus 4% of controls p=0035). This correlation was established for a delayed consultation (2 months) p 0.01. Radiological data showed that bilateral lesions and extended unilateral lesions were significantly associated with delayed smear conversion (p 0.03, p 0003). Biologically, a frank increase in CRP was statistically predictive of late conversion. (p 0.02). A positive association between the occurrence of adverse events that did not require discontinuation of treatment and delayed smear conversion was also found (p 0.02). A positive correlation has not been established for the geographical distance, the low economic level, for a body mass index below 18.5 kg/m2. In terms of bacteriology, the load of bacilli was not significantly associated with delayed smear conversion. Conclusion: Identifying predictors of late smear conversion may allow us to set up effective preventive measures to fight against the spread of the disease and limit its complications.
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